I was already approved for benefits, why is Social Security reviewing my case again?
Posted September 8, 2016 by Premier Disability Services, LLC® The Social Security Administration does not assume that you will be permanently disabled when you are granted Social Security Disability (SSDI/RSDI) or Supplemental Security Income (SSI) disability benefits. Many of the conditions that prevent Social Security recipients from working can be expected to improve with time. Accordingly, the SSA periodically reviews the cases of Social Security disability recipients to determine whether they are still unable to work and therefore still considered disabled. This process is called a “continuing disability review,” or CDR.When your application for Social Security Disability benefits is approved, the disability determination representative who handled your claim will set the dates for your continuing disability reviews (these dates are sometimes called “diaries”). The Certificate of Award you received when your claim was approved should indicate when you can expect your first review. Generally speaking, CDRs are set at every three years or every seven years.
- Medical Improvement Possible – If your case has been labeled as medical improvement possible (MIP), then you can expect a review at least once every three years. The SSA may review your case every three years if you have a condition that can reasonably be expected to improve, such as a mental illness.
- Medical Improvement Expected – In some cases, your claim could be reviewed even sooner than three years. For someone who has had their disability case classified as medical improvement expected (MIE), the case will be scheduled for a review within six to eighteen months after the applicant was first confirmed of having a disability. For example, if you were granted disability benefits while recovering from multiple knee surgeries, your case was probably classified as MIE. Additionally, babies who are awarded SSI benefits due to a low birth-weight will have their case reviewed by their first birthday. It is less likely that those over 55 will receive a CDR according to the MIE timeline.
- Medical Improvement Not Expected – You may be set to a seven year diary if you have a condition that is not expected to improve, such as blindness, autism, Parkinson’s disease, multiple sclerosis, cerebral palsy, or other chronic conditions. These cases are categorized as medical improvement not expected (MINE). In addition, those over the age of 55 are often assigned seven year diaries simply because older individuals are less likely to improve than younger persons. Even disability recipients who have undoubtedly permanent conditions, such as amputations or mental retardation, may be subject to continuing disability reviews.
- Child SSI Recipients – Child SSI recipients will have their case reviewed at the time they turn 18, regardless of their disability.
- Deviation From These Guidelines – Although the above guidelines constitute the official procedure, the fact is that SSA has much leniency in determining when to do CDRs. There are a web of overlapping guidelines that SSA uses in setting the dates for CDRs. As a result, some SSD beneficiaries may see more frequent CDRs, while others go many years without being subject to one (the more common scenario because of current budget shortfalls). In general, the standard for proving ongoing disability are less strict in continuing disability reviews compared to the initial disability determination. The majority of claimants have their benefits continued following a CDR.
- In addition to CDRs, which consist of reviewing the medical evidence in a claim, those receiving SSI will also be subject to “redeterminations.” Because SSI is a needs-based program with strict income and asset limits, the SSA regularly reviews beneficiaries’ income, resources, and living arrangements. If it is found that an individual is outside the allowable limits for SSI, then his or her SSI benefits will stop.
Re-determinations can be conducted anywhere from every one to six years. SSI claims are also subject to a re-determination when a beneficiary undergoes a change that could affect their eligibility (such as marriage).
Sources:
http://www.ssa.gov/pubs/EN-05-10153.pdf
http://www.socialsecurity.gov/pubs/EN-05-10090.pdf
By: Joyce Trudeau of Premier Disability Services, LLC®
